Tricare has said they will not cover my angioplasty for my 2 venospasms I had at Mayo. This is $21000. Has anyone else had this problem? Do I have any recourse? Susan
Hi Susan...not sure what a venospasm is...?
Can u have Mayo set you up with a payment plan? or isn't there something with Obama and insurance ... that if your household only makes so much...you don't have to pay a percentage of your bill? I think I would call Mayo and tell them you cannot afford ... what do they suggest ?
I am so sorry for this...I am blessed that our insurance company paid alot of my surgeries...??? and it looks like charges are getting to the $200,000 mark...unbelievable...
Please keep us posted...wishing you the best...Colleen
I am writing to my congressman. Mayo has already set up a payment plan. I am wondering if anyone else had this problem with them. I feel singled out. Susan
Susan,
Check your policy to see what is & isn't covered, was authorization required, and what your deductible, copay or percentage of coverage is. That being said, I would then call Tricare to find out why they aren't covering (I believe Tricare is military related, correct?) Do you have any other insurance? Then depending on what transpired from that, I can possibly put you on track with what to do next! Don't want to overwhelm you with too much information. Well, do that first, then I may be able to assist you to the next step. PS; if you don't have a copy of your insurance policy, just ask Tricare the above questions. Let me know. I will be offline for a few hours today, but will be back online tonight so if you were able to get any answers.
Susan,
Wow, I am so sorry to hear this; we go thru so much in recovery.
Is Tricare thru your employer and will your HR assist? Have you read all the detail in your policy? Have you gone to Tricare's consumer affairs section or just thru the billing section?
Was a venospasm related to aneurysm coiling or surgery; and, was the angioplasty in veins or arteries? Was all the CPT and other coding correct? I only know the term vasospasm which relates to arteries; never thought about any on veins.
Best of wishes to you; please be sure you have as much info as possible for your congressman.
Pat
I have done all that. My policy does say angioplasty in the brain is unproven. This is not true. They say it was experimental and that is not true. I have written my congressman as I said. I hope that helps. Tricare is military. My husband was in the Navy 28 years and pays for my health insurance. I heard they do this. I will not give up!
Susan, Did you explain the situation to the hospital? They have advocates that will often fight with ins. companies for you. Plus, they know other ways of getting financial help when the insurance doesn't cover the bill. This upsets me even more of how our gov't treats our military people!I just saw this! Who would I speak to at the hospital? I finally gave up as my neurosurgeon sent them a copy of the standards of practice and they still refused. I didn't have the gumption to keep fighting.
Talk to someone in the Hospital that is in the accounts receivable dept to help you find an advocate in the Hospital to help with this situation...Also, may want to contact social worker at the hospital for help...Good Luck...~ Colleen
Susan...I have so many questions...my memory lapses/blanks...I read your initial that you had coiling in 2009...and this one is initially dated 2011...
When were the stents implanted? During the coiling or during a follow-up angio?
Was the diagnosis of the need for stent implants reviewed/covered w/you to give you time to check on the approval before the stents were implanted?
Somewhere you noted your doctor had sent a "standards of practice" to Tricare...
Is that available on the Mayo website?
Wishing you the best results...
Pat
Pat, the stent was put in a year after my coiling because they said my aneurysm was leaking. The insurance approved it and it was just an overnight in the ICU. The neuro says I don't have to come back for 5 years. I do not know where he got them, I bet you can google them,Good luck to you too! I have been very blessed!
Susan...
When was the angioplasty done?
What procedure was used?
Pat